• 제목/요약/키워드: Postoperative Care

검색결과 499건 처리시간 0.021초

Permanent Tracheostomy in a Thoroughbred Mare with Arytenoid Chondritis

  • Park, Soomin;Park, Kyung-won;Lee, Eun-bee;Sohn, Yongwoo;Jeong, Hyohoon;Kang, Tae-Young;Seo, Jong-pil
    • 한국임상수의학회지
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    • 제38권5호
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    • pp.244-248
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    • 2021
  • A 10-year-old Thoroughbred mare was referred to the Jeju National University Equine Hospital with roaring, dyspnea, and weight loss. On endoscopic examination, the horse was diagnosed with right arytenoid chondritis. Surgical treatment was selected due to the failure of a previous medical treatment. Permanent tracheostomy was performed in a standing position. The horse was restrained and tied in a proper position in the stock. The cranial parts of the 2nd to 5th tracheal cartilages were resected, as were the associated skin, mucosa, muscle, and cartilages. After the stoma was formed, external mucosa and skin were sutured using a simple interrupted method. The horse was hospitalized for 22 days receiving postoperative care including antibiotics, non-steroidal anti-inflammatory drugs, dressing as required, and was pregnant six months after the surgery. A permanent tracheostomy is thought to be effective in horses with diseases causing upper respiratory tract obstruction.

안면 외상에서 연부조직 치료에 있어 미용적 재건 (Aesthetic soft tissue management in facial trauma)

  • 정규진;김태곤;이진호
    • 대한의사협회지
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    • 제61권12호
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    • pp.715-723
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    • 2018
  • Facial soft tissue injury due to trauma is common. Severe damage of soft tissue causes functional and cosmetic problems. In the initial evaluation of patients with facial trauma, airway maintenance and respiratory maintenance are the most important. The principles of treatment include adequate irrigation and debridement, primary closure, or secondary wound healing. Postoperative care such as taping, silicone gel sheeting, and sun screening is important to prevent scarring. The scalp and forehead are abundant in blood and can cause severe bleeding. The eyelid is very thin and has a multi-layered structure, requiring accurate suturing and reconstruction of the layers. It is advisable to determine the presence of hematoma in the ear and treat it. When the cheek area is damaged, it is necessary to identify and treat the damage of the parotid gland and the facial nerve branch. The lips should be sewn with the white roll of lip and vermillion.

Successful management of absent sternum in an infant using porcine acellular dermal matrix

  • Semlacher, Roy Alfred;Nuri, Muhammand A.K.
    • Archives of Plastic Surgery
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    • 제46권5호
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    • pp.470-474
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    • 2019
  • Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

Treatment of the wide open wound in the Ehlers-Danlos syndrome

  • Baik, Bong Soo;Lee, Wu Seop;Park, Ki Sung;Yang, Wan Suk;Ji, So Young
    • 대한두개안면성형외과학회지
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    • 제20권2호
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    • pp.130-133
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    • 2019
  • Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.

Removal of intraosseous hemangioma in frontal bone under direct vision through a small incision

  • Kim, Hyeon Seok;Kim, Woo Seob;Kim, Han Koo;Bae, Tae Hui
    • 대한두개안면성형외과학회지
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    • 제22권1호
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    • pp.52-55
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    • 2021
  • Complete surgical excision within a margin of normal healthy bone is the treatment of choice for intraosseous hemangioma. A 56-year-old man visited with complaints of a firm, mildly tender, immovable, and palpable mass on the right forehead (size: 1.5×1.5 cm). Non-contrast brain computed tomography performed preoperatively revealed a 1.5 cm heterogenous osteolytic lesion with suspected internal trabeculation in the right frontal bone. Under general anesthesia, a 2 cm transverse incision was made on the forehead skin rather than bicoronal incision. Full-thickness en bloc resection of the frontal bone including the mass was performed. The frontal bone was removed with care taken not to damage the frontal sinus mucosa. The frontal sinus was sealed with a collagen patch (Tachocomb) and a cranioplasty was performed using bone cement. At 6 months postoperative, a clean wound was confirmed without any complications, and there was no local recurrence. Surgical excision of intraosseous hemangioma in the frontal sinus bone can be performed via direct incision or the bicoronal approach. In this case, the direct incision approach was used to achieve smaller scars and faster recovery than the bicoronal approach.

The humeral suspension technique: a novel operation for deltoid paralysis

  • de Joode, Stijn GCJ;Walbeehm, Ralf;Schotanus, Martijn GM;van Nie, Ferry A;van Rhijn, Lodewijk W;Samijo, Steven K
    • Clinics in Shoulder and Elbow
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    • 제25권3호
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    • pp.240-243
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    • 2022
  • Isolated deltoid paralysis is a rare pathology that can occur after axillary nerve injury due to shoulder trauma or infection. This condition leads to loss of deltoid function that can cause glenohumeral instability and inferior subluxation, resulting in rotator cuff muscle fatigue and pain. To establish dynamic glenohumeral stability, a novel technique was invented. Humeral suspension is achieved using a double button implant with non-resorbable high strength cords between the acromion and humeral head. This novel technique was used in two patients with isolated deltoid paralysis due to axillary nerve injury. The results indicate that the humeral suspension technique is a method that supports centralizing the humeral head and simultaneously dynamically stabilizes the glenohumeral joint. This approach yielded high patient satisfaction and reduced pain. Glenohumeral alignment was improved and remained intact 5 years postoperative. The humeral suspension technique is a promising surgical method for subluxated glenohumeral joint instability due to isolated deltoid paralysis.

Factors that Affect Remission of Chemotherapy-Induced Peripheral Neuropathy Symptoms: Short-Term Prospective Study

  • Jeong, Gay Suk;Choi, Jin Yi;Choi, Heejung
    • Journal of Korean Biological Nursing Science
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    • 제24권2호
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    • pp.86-94
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    • 2022
  • Purpose: Patients experiencing chemotherapy-induced peripheral neuropathy (CIPN) apply various palliative care as well as drugs in their daily life to alleviate symptoms. There is a need to identify the influence of these efforts and patients' psychosocial status on the relief of CIPN symptoms. This short-term prospective study investigated how prescription drugs, non-pharmacological behaviors (exercise, massage, and heat therapy), and psychological states (social support, depression, and anxiety) affected CIPN symptoms. Methods: Participants scheduled to receive postoperative platinum or taxane-based chemotherapy were enrolled consecutively. CIPN was measured with the Neurotoxicity-12 subscale of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity-12 instrument. Data were collected three times during the 4 or 5 cycles of chemotherapy. Results: At the end of the 2nd chemotherapy cycle, 93.1% of participants reported CIPN symptoms. Multiple regression analyses showed that a heat therapy (β= -.34, p< .001), massage (β= -.21, p= .012), and walking 5 times or more per week (β= -.26, p= .021) provided relieve for CIPN symptoms. Depression (β= .19, p= .027) significantly exacerbated CIPN symptoms. Conclusion: These results suggested that a comprehensive management program that includes walking, heat therapy, massage, and mood therapy should be encouraged. Moreover, patients should be educated at chemotherapy initiation to understand appropriate interventions that can relieve CIPN symptoms.

Rectal Prolapse Due to Rectal Polyp Associated with Chronic Eosinophilic Proctitis in a Rex Rabbit

  • Han, Jang-Hee;Ha, Minjong;Ahmed, Sohail;Woo, Sang-Ho;Oh, Jeong-Seop;Yeon, Seong Chan
    • 한국임상수의학회지
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    • 제39권2호
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    • pp.75-80
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    • 2022
  • An 11-year-old male Rex rabbit (Oryctolagus cuniculus) had a rectal prolapse induced by a polypoid mass. The mass was highly vascularized with a cauliflower-like appearance. Anorectal papilloma was suspected, and fine needle aspiration cytology showed eosinophilic inflammation. After surgical removal of the polyp, postoperative care was given, such as systemic antibiotics and analgesics. In the re-examination, the rabbit was resolved, and there were no complications. Histopathological examination of the removed polyp indicated chronic eosinophilic proctitis to be the cause of the inflammatory condition of the protruding rectal polyp.

A plunging ranula in a child with holoprosencephaly: a case of unique pathophysiology and difficult airway management

  • Watanabe, Takuma;Yokoyama, Atsushi;Shimizu, Satoshi;Bessho, Kazuhisa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권4호
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    • pp.232-236
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    • 2022
  • A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

Effect of Cytoskeletal Manual Therapy, a Novel Soft Tissue Mobilization Technique, on Axillary Web Syndrome after Axillary Lymph Node Dissection: A Case Report

  • Hyun-Joong Kim;Seong-Hyeok Song;Seungwon Lee
    • Physical Therapy Rehabilitation Science
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    • 제11권4호
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    • pp.464-470
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    • 2022
  • Objective: Axillary web syndrome (AWS) is a condition comprising fibrous band-like cords that appear in the axilla of patients after axillary lymph node dissection (ALND) during breast cancer surgery and result in pain and reduced mobility. The cords appearing with AWS are hardened veins or lymphatic vessels. Manual therapy and stretching are recommended for pain control and mobility improvement. Therefore, this study investigated the effect of cytoskeletal manual therapy (CMT), which is a new soft tissue mobilization technique. Design: A case report Methods: A 41-year-old woman with AWS after breast cancer surgery and ALND visited a physical therapy clinic because of shoulder pain, decreased function, and decreased mobility. The cords were palpable and pain occurred 2 weeks after surgery. CMT was performed three times per week for a total of 6 weeks. Her pain intensity, range of motion (ROM), and shoulder function were measured. Results: Measurements were performed after 2 weeks and 6 weeks of CMT and evaluated using the numeric pain rating scale (NPRS). Her pain intensity largely decreased after 2 weeks (4-point score reduction) and after 6 weeks (5-point score reduction) of CMT. After CMT, her full ROM was restored and her shoulder function was improved (7-point score reduction). Conclusions: CMT is effective for pain control, mobility improvement, and functional improvement of patients with AWS.